竖脊肌平面阻滞在加速康复外科应用的研究进展

Research progress of erector spinae plane block in enhanced recovery after surgery

加速康复外科(ERAS)指采用一系列经循证医学证实有效的围手术期优化措施减少外科应激、加快术后康复。不同镇痛药物或镇痛方法的联合使用,通过不同的作用机制发挥疗效,降低单一措施的不良反应。ERAS包含术后硬膜外镇痛、术后静脉自控镇泵(PCIA)、非甾体抗炎药物、伤口浸润渗透、鞘内注射及外周神经阻滞等措施。竖脊肌平面阻滞(erector spinae plane block,ESPB)是在竖脊肌深面及椎体横突之间注射局麻药物,作用于筋膜间隙的平面阻滞新技术。超声引导下ESPB具有可视性、安全度高、不良反应少、创伤小应用广泛、易于掌握等优势。本文就ESPB运用于加速康复外科的最新临床应用及研究进展进行总结。

Enhanced recovery after surgery(ERAS)refers to the adoption of a series of perioperative optimization measures proven effective by evidence-based medicine to reduce surgical stress and accelerlate postoperative rehabilitation.The combination of different analgesic drugs or analgesic methods could exert the curative effect through different action mechanism and reduce the adverse reaction of single measure.ERAS includes postoperative epidural analgesia,patient-controlled intravenous analgesia(PCIA),nonsteroidal anti-inflammatory and analgesic drugs,wound infiltration,intrathecal injection and peripheral nerve block,etc.Erector spinae plane block(ESPB)is a new technique to block the fascia space by injecting local anaesthesia between the deep surface of erector spine muscle and the transverse process of vertebral.Under the guidance of ultrasound,ESPB has the advantages of visibility,high safety,less adverse reactions,less trauma,wide application and easy to grasp.This report summarizes the latest clinical application and research progress of ESPB in ERAS.